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Biomedical subjects

J S Kelley

Publications and source records attributed to J S Kelley.

At least 19 recordsLinked to original sources
PubMed1988

Increased intraocular pressure in the immediate postoperative period after extracapsular cataract extraction.

We evaluated the immediate intraocular pressure increase after extracapsular cataract surgery in 58 eyes. Two to three hours postoperatively, 34 eyes (59%) developed an intraocular pressure greater than or equal to 25 mm Hg. We found an intraocular pressure of at least 40 mm Hg in seven eyes. Mean intraocular pressure two to three hours postoperatively was 8.9 +/- 9.8 mm Hg greater than the preoperative intraocular pressure. The use of intraocular sodium hyaluronate had no apparent effect on intraocular pressure.

Aged↗
PubMed1985

Early complications following Q-switched neodymium: YAG laser posterior capsulotomy.

A prospective evaluation was conducted of Q-switched neodymium: YAG laser capsulotomy in 53 eyes followed for one postoperative month. The first 31 eyes were seen at two-hour intervals for the first eight hours, and the remaining eyes were checked only at the second postoperative hour during that day. Eighty-nine percent of eyes required a pulse setting of less than 1.7 mJ to successfully penetrate the posterior capsule. Visual acuity was improved in 91% of eyes. A transient immediate postoperative intraocular pressure (IOP) elevation was seen in over 75% of treated eyes, and one-third had an IOP elevation greater than 10 mmHg over the preoperative IOP. This elevation was most common in glaucomatous eyes and occurred in almost one-half of the treated eyes by the second postoperative hour. This IOP change did not correlate with the degree of inflammation, bleeding, anterior chamber debris, or total energy delivered. Minimal iris bleeding occurred in 9% of treated eyes and was associated with iridocapsular adhesions. Eighty-one percent of eyes with posterior chamber implants developed some degree of lens damage.

Adult↗
PubMed1983

Funduscopically controlled scotometry.

The following is a brief summary of the results in our ten groups of cases. The positive features of laser scotometry are emphasized. The normal response is well defined: there are no uncertain blind spot margins. The peripheral field is probably extended beyond 60 degrees nasally and superiorly. The size and shape of the small central scotomas associated with macular holes are easily defined and correlated directly with the visible edge of the hole. This result is distinct from the intact subjective response with cystoid maculopathy and surface wrinkling retinopathy. Plotting the margins of peripheral abnormalities such as retinal detachments, retinoschisis, and lattice degeneration is easily done. Schisis is distinguished by an absolute scotoma. This scotometry is facilitated by a larger "normal" field with the laser instrument. Lattice degeneration causes a field defect. A branch retinal artery occlusion shows a slightly jagged border, difficult to detect by standard methods. A cotton-wool spot does not show a total nerve-fiber-bundle defect. Small absolute scotomas are correlated with degenerative changes within nevi. Degenerative changes over small melanomas--ie, the orange spots--also produce absolute field defects. "Bear track" lesions have a normal field, whereas dense black isolated lesions are associated with absolute scotomas. In macular degeneration the bright laser test object is usually visible to the patient within detachments of neuroepithelium, detachments of the pigment epithelium, and over recent subretinal neovascularization. Response is absent over sharply-defined zones of pigment atrophy and over late subretinal fibrovascular mounds. In contrast to the degenerative cases, a selection of hereditary cases showed no direct correlation between the zone of pigment atrophy and the zone of absolute scotoma. The scotoma was much larger than the atrophic region, extending to the edge of the cream-colored subretinal spots. The laser target method sharply defines the absolute scotoma associated with papilledema. It also detects a slit-like nerve-fiber-bundle defect, suggesting progressive damage. Small, but possibly not the earliest, scotomas associated with glaucoma can be detected with laser scotometry. In some cases they are detected when the Goldmann perimetric field is normal. Late residual visual fields are easily defined, since fixation can be directly monitored. The vertical border of hemianopic defects can be defined within one degree of accuracy.

Adult↗
PubMed1982

Argon laser photocoagulation treatment of iris cysts following penetrating keratoplasty.

Two patients with iris cysts were successfully treated with argon laser photocoagulation. There was no evidence of recurrence of the cysts 51/2 and four years after treatment. To our knowledge, these cases represent the first reported cases of iris cysts following keratoplasty treated with argon laser photocoagulation that have documented long-term follow-up.

Adult↗
PubMed1980

Sarcoidosis with neovascularization of the optic nerve head.

A 25-year-old man with systemic sarcoidosis had neovascularization of the optic nerve heads and associated bilateral vitreous hemorrhages. Oral administration of prednisone produced a prompt resolution of these unusual neovascular fronds and cleared the vitreous hemorrhages.

Adult↗
PubMed1980

Retinal fluorograms using oral fluorescein.

Sodium fluorescein may be safely administered orally. The resulting angiograms serve to document the presence or absence of dye leakage in the same manner as venous injection. The oral route of administration is of particular benefit for use in children, patients with inaccessible veins, and patients participating in studies of late retinal vascular leakage, such as postoperative cystoid macular edema. Serum concentrations of the dye plateau between thirty minutes and one hour, at levels approximating those obtained by intravenous injection.

Administration, Oral↗
PubMed1980

Siphon suction for vitrectomy.

An intravenous container placed below the level of the surgical field can provide a gentle, safe level of suction (+/- 76 mm Hg). This is particularly useful in performing a delicate open-sky anterior vitrectomy.

Corneal Transplantation↗
PubMed1979

Peripheral retinal neovascularization in rheumatic fever.

During a two-year period, a 15-year-old boy had three major manifestations of rheumatic fever, ie, chorea, rash, and carditis. Following the acute carditis, peripheral retinal neovascularization appeared in the left eye. Associated transient hemiparesis suggests that emboli may account for the retinal vascular occlusion. Rheumatic fever should be considered in the medical survey of patients who have retinal new vessels of obscure origin.

Adolescent↗
PubMed1979

Retinal fluorography using oral fluorescein.

Fluorescein sodium can be administered safely by mouth. The resulting fluorograms are useful in demonstrating many retinal conditions characterized by bright late leakage, such as cystoid macular edema. Oral administration of fluorescein may be preferred in studies of children, patients with difficult veins, and in some surveys of large patient populations.

Administration, Oral↗
PubMed1979

Acute ocular leukemia.

A 71-year-old woman had a history of recent weight loss and bilateral decreased visual acuity, bilateral serous detachment, and mental depression. Fluorescein angiograms showed a myriad of retinal pigment epithelial leakage points. Despite extensive evaluation, the cause of her weight loss and ocular process remained uncertain until her death, when postmortem examination revealed leukemia infiltrates of many organs, including the choroid. After death, we correlated the clinical signs and fluorescein angiograms with the histopathologic findings. This case shows that choroidal disease may be a symptom of undetected leukemia.

Aged↗
PubMed1979

Rhegmatogenous retinal detachment with retinal telangiectasia.

A 34-year-old man with unilateral retinal telangiectasia developed a bullous retinal detachment. A horseshoe retinal tear was found at 12 o'clock. The detachment resolved with placement of an encircling scleral buckle. The prompt and permanent resolution of subretinal fluid supported our belief that this was a rhegmatogenous retinal detachment.

Adult↗
PubMed1979

Laser scotometry in drusen and pits of the optic nerve head.

Laser scotometry is an accurate means of detecting dense blind spots. A small low-energy spot is guided across the fundus from nonseeing to seeing areas. Patient responses are recorded on fundus photographys, allowing direct correlation with fundus pathology. Accuracy to less than 1 degree is feasible. All typical optic nerve drusen tested with this technique had field defects. In cases of optic nerve pits, dense scotomas correlated with the shape of visible nerve fiber defects rather than with the shape of serous retinal detachments.

Adult↗
PubMed1978

Retinal hemorrhages in subacute carbon monoxide poisoning. Exposures in homes with blocked furnace flues.

Three incidences of carbon monoxide poisoning occurred owing to defective heating systems. Twelve persons were affected; of these, three lost their lives. Because the symptoms of carbon monoxide poisoning closely resemble flu and other common illnesses, correct diagnosis was not made as promptly as it might have been. Hemorrhages were found in the nerve fiber layer of the retina in all five of the patients who had been exposed for more than 12 hours. It is our contention, therefore, that complete examination of the patient should always include ohthalmoscopy, and that the finding of retinal hemorrhages, in addition to nausea, headache, and dizziness, should aler the physician to the possibility of carbon monoxide poisoning.

Accidents, Home↗
PubMed1978

Whiplash maculopathy.

Maculopathy in three patients, caused by whiphash injury demonstrated three features that are characteristic of this subtle disturbance of the macula: a history of flexion-extension, head and neck trauma; a history of immediate mild reduction of central visual acuity in one or both eyes; and grayish swelling of the foveal zone accompanied by a small (50 to 100-mu) pit or depression in the fovea. In patients with this disturbance, the retinal opacification and the visual disturbance are transient, but the tiny depression in the retina with its whitish border is permanent.

Accidents, Traffic↗
PubMed1978

Doppler ultrasound flow detector used in temporal artery biopsy.

A doppler ultrasound flow detector can be helpful in performing a temporal artery biopsy. The anatomical location of the arteries can be traced on each side of the patient's head during the preoperative stage, and the flow pattern can be compared with the findings on simple palpation. Selection of a vessel for biopsy may thus be influenced. The detector can also be used under sterile conditions to locate the artery when the injection of local anesthesia has made palpation more difficult, thereby facilitating dissection of an adequate specimen.

Biopsy↗
PubMed1978

Correlation of clinicopathologic findings in a patient. Congenital night blindness, branch retinal vein occlusion, cilioretinal artery, drusen of the optic nerve head, and intraretinal pigmented lesion.

The ocular clinicopathologic features of this unique patient were congenital stationary night blindness, drusen of the optic nerve head, cilioretinal artery, intraretinal pigmented lesion, and branch retinal vein occlusion. Photocoagulation therapy led to total disappearance of the neovascular tissue, clinically and histopathologically. Histopathologic examination showed an occluded branch vein associated with a sclerotic retinal arteriole. Peripheral to the site of venous occlusion, inner ischemic retinal atrophy was present. The normal complement of rod and cone photoreceptors supports the view that the night blindness in this case was an abnormality in the neural transmission and not on a morphological basis. The pigmented intraretinal lesion proved to be a localized area of retinal and choroidal neovascularization with anastomosis and secondary retinal pigment epithelial hyperplasia. This lesion was identical to Fuchs' dot of myopia but out patient was hyperopic.

Argon↗